Söderman Mirkka, Bondesson Anna, Pettersson Tina, Gustafsson Lena-Karin
Division of Caring Science, School of Health, Care and Social Welfare, Mälardalen University, Eskilstuna, Sweden.
J Multidiscip Healthc. 2023 Aug 2;16:2207-2216. doi: 10.2147/JMDH.S409879. eCollection 2023.
Reablement as a concept includes a health-promoting perspective with the goal of strengthening health and the ability to perform and participate in daily activities, a broader perspective than in general home care and rehabilitation. Reablement interventions have shown to be both more effective and to a greater extent improve the function and health-related quality of life of older persons when compared to traditional home-based care. Success factors for intensive-home-rehabilitation (IHR), an intervention based on the reablement concept, have been described earlier; however, there is a lack of knowledge about why some persons do not recover despite receiving IHR.
The aim was to shed light on the older persons' conditions during IHR from the perspective of the rehabilitation team members and to describe obstacles to recovery.
Qualitative analysis of health and care records of persons (65+) who received IHR (n=19) performed by an interprofessional team.
The analysis revealed various problematic situations, dilemmas, that occurred in the older persons' lives during IHR, as well as their consequences and the strategies employed by the older persons as a result. IHR aspects perceived as successful by the older persons also emerged, as well as differences in experiences of the physical and mental aspects of the IHR. Analysis also revealed reasons why the IHR might be experienced as broadly successful.
The older persons seemed to be satisfied with IHR and achieved their goals; however, some seemed to need more time to reach their goals. Background factors such as having additional diagnoses and living alone might affect the rehabilitation process.
The study provides knowledge regarding the importance of IHR for the recovery process for the increasing numbers of older persons, which might also be useful in other patient groups requiring otherwise long-term rehabilitation and recovery such as after covid-19 infection.
康复作为一个概念，包含促进健康的视角，目标是增强健康以及执行和参与日常活动的能力，这一视角比一般家庭护理和康复更为宽泛。与传统居家护理相比，康复干预已被证明更有效，且能在更大程度上改善老年人的功能和与健康相关的生活质量。基于康复概念的强化居家康复（IHR）干预的成功因素已在之前有所描述；然而，对于为何有些人尽管接受了IHR却未康复，仍缺乏了解。
旨在从康复团队成员的角度阐明老年人在IHR期间的状况，并描述康复的障碍。
对由跨专业团队实施IHR的65岁及以上人群（n = 19）的健康和护理记录进行定性分析。
分析揭示了老年人在IHR期间生活中出现的各种问题情境、困境及其后果，以及老年人因此采取的策略。还出现了老年人认为IHR成功的方面，以及IHR身心方面体验的差异。分析还揭示了IHR可能被广泛视为成功的原因。
老年人似乎对IHR感到满意并实现了目标；然而，有些人似乎需要更多时间来实现目标。诸如患有其他疾病和独居等背景因素可能会影响康复过程。
该研究提供了关于IHR对越来越多老年人康复过程重要性的知识，这对于其他需要长期康复和恢复的患者群体（如新冠病毒感染后）可能也有用。
